The Relationship Between Developmental Dysplasia of the Hip (DDH) and Congenital Talipes Equinovarus (CTEV)-A Retrospective Case Series

Backgrounds There is no consensus if a relationship exists between idiopathic congenital talipes equinovarus (CTEV) and developmental dysplasia of the hip (DDH). Our research aim was to provide a contemporary Australian population statistical relationship between DDH and idiopathic CTEV, compared to published data. Methods We conducted a retrospective data analysis of a continuous sample of infants with idiopathic CTEV, who attended a Ponseti Clinic at Sydney Children's Hospital, born between 2010 and 2019. The prevalence of DDH requiring treatment was diagnosed utilising screening ultrasonography and compared to the most valid population data from Australia. The relative risk compared to this data was also determined. Results There were 250 subjects who met the inclusion criteria and had complete datasets for analysis. The prevalence of DDH in our idiopathic CTEV study population was 52.9 (95% CI 27.6-90.5) per 1000. This represents a higher prevalence rate than Western Australian and South Australian datasets, with 9.5 (95% CI 8.9-10.1) and 5.0 (95% CI 4.6-5.5) per 1000, respectively. The relative risk of DDH in our idiopathic CTEV study population was 5.59 (95% CI 3.21-9.73, p < 0.0001) and 10.50 (95% CI 6.01-18.34, p < 0.0001), compared to Western Australian and South Australian population datasets, respectively. Conclusion Our study findings support a positive correlation between idiopathic CTEV and DDH. The relative risk of DDH in the idiopathic CTEV population is 5-10 times higher than the general Australian population. When selective hip ultrasound screening is used, we believe idiopathic CTEV should be considered a risk factor for DDH.